Professional Documents
Culture Documents
CONFIDENTIAL
1-(1) Application Form
Master's Degree and Internship Program of African Business Education Initiative for Youth
/ SDGs Global Leadership Program for FY2022
APPLICATION FORM
Reg.No
Instruction
1. Handwritten form is NOT acceptable
2. Fill in the form in English
3. It is a MUST to fill all the YELLOW columns (Please write "N/A" if not applicable)
4. Write years in western calendar
5. Write proper nouns in full without abbreviation
6. Sign all pages on the bottom of right-hand corner after printing
7. Check your application form using the check list at the bottom of this application form
1. Personal Information
1-1. Course (JICA may suggest appropriate course during the 2nd Selection)
Master's Degree and Internship Program of African
SDGs
BusinessGlobal
Education Initiative for Youth Color Photo
(4cm×3cm)
● Leadership
1-2. Number (Not need to fill in. JICA will inform after selection Procedures) Paste your photo
Program taken within
6 months.
Family Name
First Name
Other Name
(If any)
Date of Birth
Sex (Day/Month/Year / /
)
Age
Nationality (As of
1/4/2022)
Resident Country
TEL
City/Town
(Primary)
TEL
State/Province
(Secondary)
Passport
Email
possession
Province &
TEL Email
Country
2
Name Relationship
Province &
TEL Email
Country
1
ABE Initiative 7th Batch/SDGs Global Leadership Program FY2020
CONFIDENTIAL
1-(1) Application Form
1) All applicants are required to specify first, second and third choice of Universities by reference to "2-(1):
University Information for the Applicants".
Master/PhD
Name of Selected
Course (Master ONLY
Priority Code University and Graduate School Course / Program / Degree Supervisor of choice*
if you apply for
Graduate School
ABE Initiative)
* If you wish to apply for a PhD, please make sure to fill in "Supervisor of choice".
In case of Master's program, please fill in if your desired university requires to choose the
supervisor.
Please check the list of universities for details.
2
ABE Initiative 7th Batch/SDGs Global Leadership Program FY2020
CONFIDENTIAL
1-(1) Application Form
3. Educational Background
Instruction
1.Exclude kindergarden education and nursery school education.
2.Preparatory education for university admission is included in upper secondary education.
3.If you attended multiple schools at the same level of education due to moving house or readmission to university,
modify level column and write the schools in the separate rows.
4.Any school years or levels skipped or repeated should be indicated in the Remarks column.
5. End date for Higher Education should match with the date on the guraduate certificate which you submit.
6. Academic Degree must be filled for Higher Education level. (If not obtained any degree, write "N/A")
From /
Primary
Education
To /
From /
Lower
Secondary
Education
To /
From /
Upper
Secondary
Education
To /
From /
Higher
Education
To /
From /
To /
From /
To /
From /
To /
Please write the reasons in Remarks if you need to make a supplement or explanation for the instruction 4, 5, or 6.
Remarks
3
ABE Initiative 7th Batch/SDGs Global Leadership Program FY2020
CONFIDENTIAL
1-(1) Application Form
1) Language Proficiency
Excellent: Refined fluency skills and topic-controlled
Listening discussions, debates & presentations. Formulates
strategies to deal with various essay types,
including narrative, comparison, cause-effect &
Speaking argumentative essays.
Name of scholarship
Duration From / To /
3) Are you currently applying for any scholarship(s), other than ABE Initiative?
Name of scholarship
4) Have you ever participated in any training course in your country or abroad including any offered by JICA?
Name of the
Country you visited
institution or agency
Duration From / To /
4
ABE Initiative 7th Batch/SDGs Global Leadership Program FY2020
CONFIDENTIAL
1-(1) Application Form
Organization
Department / Division
Position
Date of assignment
Date of employment / / to the present / /
position
Province &
TEL Email
Country
Date Signature
Name
Department /
Division
Position
Official
Stamp
TEL
5
ABE Initiative 7th Batch/SDGs Global Leadership Program FY2020
CONFIDENTIAL
1-(1) Application Form
5. Work Experience
Provide the information of your work experience following the most recent one.
The first row (most recent one) will be filled automatically if 4-1 is correctly filled.
* Please write the month and year as of you apply for this program.
Ex,If you applied for this program end of October in 2021, Please choose October as month and 2021 as
year.
Period of Full/
Organization Department Position From / To Type
Working Part
From /
*To /
From /
To /
From /
To /
From /
To /
From /
To /
From /
To /
From /
To /
6
ABE Initiative 7th Batch/SDGs Global Leadership Program FY2020
CONFIDENTIAL
1-(1) Application Form
6. Medical History
Name of medicine
If yes, please attach your doctor's letter (preferably, written in English) that describes current status of
your illness and agreement to join the program
d) Please indicate any needs arising from disabilities that might necessitate additional support or facilities.
NOTES: Disability does not lead to exclusion of persons with disability from the program. However, upon
the situation, you may be directly inquired by the JICA official in charge for a more detailed account of
your condition.
b) Have you ever been a patient in a mental clinic or been treated by a psychiatrist?
7
ABE Initiative 7th Batch/SDGs Global Leadership Program FY2020
CONFIDENTIAL
1-(1) Application Form
7. Declaration
declare that I apply for the Master’s Degree and Internship Program of African Business Education Initiative for Youth (ABE Initiative) /
SDGs Global Leader with a full understanding of the “General Information”, especially the articles stipulated below:with a full
understanding of the “General Information”, especially the articles stipulated below:
(1) APPLICATION
1. all the information answered and provided in this application form by me, is true and accurate to the best of my knowledge and
ability. My application will be cancelled if any information is proven to be false.
2. all the information provided by me in this application form had been approved by my supervisor in my organization
(Required only for Governmental Officials (including public organizations) and/or Educators.)
3. an application form which is incomplete or missing any necessary document(s) will be deemed ineligible and not considered.
4. the selection procedure and results rest entirely with JICA as the secretariat of ABE Initiative. No inquiries or objections by
applicants regarding the result of the selection process will be considered.
(2-2) When I am accepted for the SDGs Global Leadership Program, I agree
2-2-1. that the objective of the program which is written in G.I. Therefore, I will participate in additional programs as being instructed in G.I
if necessary.
2-2-2. that I am required to contribute to the development of my nation’s long-term good relationship with Japan after completing the
course in Japan,
2-2-3. that the objective of the program is not provision of employment in Japan upon completion of the program.
【Privacy Policy】
(1) Scope of Use
Any information used for identifying individuals that is acquired by JICA will be stored, used, or analyzed only within the scope of JICA
activities. JICA reserves the right to use such identifying information and other materials in accordance with the provisions of this Privacy
Policy.
(2) Limitations on Use and Provision
JICA shall never intentionally provide information to a third party that can be used to identify individuals, with the following three exceptions:
(a) legally mandated disclosure requests;
(b) the information provider grants permission for information disclosure to a third party;
(c) JICA commissions a party to process information collected, in which case the information provided will be within the scope of the
commissioned tasks.
(3) Security Notice
JICA takes any measures required to prevent leakage, loss, or destruction of acquired information, and to otherwise properly manage such
information.
JICA would appreciate it if the participants of the programs grant the participants themselves portrait right license to JICA for photos and
images taken described above.
It is, however, not a requirement of the programs. The participants do not agree to grant the participants themselves portrait right license to
JICA, has absolutely no problem in participating the programs. JICA respects the intention of each Participant.
・I understand and fully agree to the following terms and conditions set forth above.
・I will be subject to any penalties imposed as a consequence of my failure to abide by the above terms and conditions.
・I understand the intention of JICA on “Portrait Right Policy” mentioned above, and my intention for usage/publication of photographs
and videos including the portrait of myself by JICA for the purpose above is as follows:
Agree Disagree
・I certify that the statements I made in this form are true, complete and correct to the best of my knowledge and belief.
Name of Applicant:
Signature:
8
ABE Initiative 7th Batch/SDGs Global Leadership Program FY2020
CONFIDENTIAL
1-(1) Application Form
Check List
Is the full name written as shown on the Passport? (Wrong spelling etc.)
(National ID is acceptable if the applicant does not own a Passport)
1
Is the date of birth same as on the Passport or ID?
Is your age between 22 to 39? (if not, check qualified age at JICA overseas office in charge of your country)
Is the name of supervisors chosen from the professor list in the University Information?
(If applying for ABE Initiative) Are you applying for Master course (Not doctor course)?
2
(If applying for PhD(SDGs course) Is the section "supervisor of choice " filled out?
Did you check the deadline of Submission Period of Application Documents to the University?
Please note that some universities have earlier application deadline.
Is the schooling years corresponded to the years specified in University Diploma and Academic Transcript?
Is the name of the degree same as in the "University Diploma" and "Academic Transcript"?
3 Is the total schooling years over minimum academic years for Bachelor's degree? your total schooling
years-> 0 years
If the schooling years does not match with the regular academic period, is it explained in the Remarks
column?
4 Is the applicant applying for any scholarship other than ABE Initiative?
Is the name of organization, department, and position correctly mentioned? (No abbreviation is allowed)
5 Did you confirm that your present orantization is not private sector If appying for SDGs course ?
9
School CoName
Graduate School of Global Food Resources [Special entrance exam only for international students]
Master's Program
Doctoral Course
Specialized Course
-Economic Policy Course
-Business Management Course
Doctoral Program
Transdisplinary Life Science Course ,Biosystems Science Course, Division of Soft Matter
Biosystems Science Course
Veterinary Medicine
Infectious Diseases
1 Marine Bioresource and Environmental Science
Veterinary Science
Department of Geophysics
Dentistry Program / Fundarmental Dentistry Course
Dentistry Program / Oral Health Science Course
Dentistry Program / Medical Engineering Course
Dentistry Program / Food and Eating Science [Shokugaku] Course
Department of Environmental Studies for Advanced Society
Civil and Environmental Engineering
Global Governance and Sustainable Development(G2SD)
Divison of Biological Resource Sciences, Department of Resource and Environmental Economics
(https://pepp.hass.tsukuba.ac.jp/)
Degree Programs inHumanities and Social Sciences
Degree Programs in
Humanities and
Social Sciences
Department of Engineering・Special Doctoral Program for Green Energy Conversion Science and
Technology
Energy Materials Science Course
Department of Engineering・Special Educational Program on River Basin Environmental Sciences
Department of Engineering・Environmental and Social System Science Course・River Basin
Environmental Science Major
Environmental and Social System Science Course
Civil and Environmental Engineering Course
International Graduate Program in the Field of Civil Engineering and Infrastructure Studies
Department of Environment Systems
Department of International Studies
Department of International Studies
Department of Socio-Cultural Environmental Studies
Department of Agricultural and Resource Economics
International Program in Agricultural Development Studies (IPADS)
Department of Global Agricultural Sciences
Master of Public Policy, International Program (MPP/IP)
Foreign Service Sub-Program within the Global Governance program
Asian Public Policy Program
Department of Biotechnology and Life Science
Department of Bio-Functions and Systems Science
Department of Food and Energy Systems Science
Department of Agriculture
International Innovative Agricultural Science Cource
International Innovative Agricultural Science Program
(Special Program)
Department of Biological Production Science
Department of Applied Life Science
Department of Symbiotic Science of Environment and Natural Resources
Department of Agricultural and Environmental Engineering
Department of Science on Agricultural Economy and Symbiotic Society
Department of Architecture and buiding Engineering
Department of Civil and Environmental Engineering
International Studies
Department of Computer Science and Communications Engineering
Major in Global Society
Major in Policy Sciences
Information, Production and Systems Engineering
Department of Civil and Environmental Engineering
Department of Earth Sciences, Resources and Environmental Engineering
International MBA
MSc in Finance
Economics Course
Mechanical Engineering
Applied Chemistry and Chemical Engineering
Electrical Engineering and Electronics Engineering
Informatics
Architecture
Systems Design
One-year Master’s Program of Public Policy (MP1)
Two-year Master’s Program of Public Policy (MP2)
Macroeconomic Policy Program (1year)
Macroeconomic Policy Program (2years)
GRIPS Global Governance Program (G-cube)
Policy Analysis Program
Science, Technology and Innovation Policy Program
International Graduate Program on Civil and Environmental Engineering
International Graduate Program on Renewable Enegy System Engineering
Interdisciplinary Education Program for Applied Science and Technology in Global Environment
Biological Functions and Medical Control
Physics Course, Dept of Fundamental Sciences
Chemistry Course, Dept of Fundamental Sciences
Materials Science and Technology Course, Dept of Advanced Materials Science and Technology
Applied Chemistry and Chemical Engineering Course, Dept of Advanced Materials Science and
Technology
Advanced Mechanical Science and Engineering Course, Dept of Advanced Materials Science and
Technology
Social Systems Engineering Course, Dept of Advanced Materials Science and Technology
Information Engineering Course, Dept of Electrical and Information Engineering
Electrical and Electronic Engineering Course, Dept of Electrical and Information Engineering
Human Sciences and Assistive Technology Course,
Dept of Electrical and Information Engineering
Life Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Applied Life and Food Sciences Course, Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Agriculture and Bioresources Course,
Dept of Life and Food Sciences
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Environmental Science for Agriculture and Forestry Course,
Dept of Environmental Science and Technology
Architecture and Civil Engineering Course, Dept of Environmental Science and Technology
Earth Science Course,
Dept of Environmental Science and Technology
Natural Disaster and Environmental Science Course, Dept of Environmental Science and Technology
Field Research in the Enviromental Sciences Course, Dept of Environmental Science and Technology
Field Research in the Enviromental Sciences Course, Dept of Environmental Science and Technology
Field Research in the Enviromental Sciences Course, Dept of Environmental Science and Technology
Field Research in the Enviromental Sciences Course, Dept of Environmental Science and Technology
Field Research in the Enviromental Sciences Course, Dept of Environmental Science and Technology
Field Research in the Enviromental Sciences Course, Dept of Environmental Science and Technology
Field Research in the Enviromental Sciences Course, Dept of Environmental Science and Technology
International Graduate
Program for Interdisciplinary Study in Science and Technology
Graduate School of Integrated Sciences for Life/Program of Life and Environmental Sciences
Division of Humanities and Social Sciences / International Peace and Co-existence Program
Division of Humanities and Social Sciences / International Economic Development Program
Division of Educational Sciences / International Education Development Program
Civil and Environmental Engineering
Transportation and Environmental Systems Program
Mechanical Engineering Program
Mechanical Engineering Program
Mathematics Program
Physics Program
Earth and Planetary Systems Science Program
Basic Chemistry Program
Division of Advanced Science and Engineering / Transdisciplinary Science and Engineering Program
Veterinary Medicine
Veterinary Medicine
Veterinary Medicine
Veterinary Medicine
Veterinary Medicine
Veterinary Medicine
Veterinary Medicine
Graduate Course in Earth and Geoenvironental Science
General
Special program in bioresource utilization science
of fungus and mushroom/ Master of Agriculture
Special Program in English
Molecular Science
Molecular Science
Molecular Science
Mathematical Sciences
Biology and Environmental Science
Earth's Evolution and Environment
Civil and Environmental Engineering
Mechanical Engineering Course
Chemistry and Biology/Biology and Envilonmental Science
Masters Programme,
Tropical Medicine Course
Masters Programme,
Health Innovation Course
Department of Science/
Chemistry
Department of Science/
Earth and Environmental Sciences
Department of Civil and Environmental Engineering and Architecture/
Civil and Environmental Engineering
Department of Civil and Environmental Engineering and Architecture/
Urban and Regional Planning and Design
Department of Civil and Environmental Engineering and Architecture/
Architecture and Building Engineering
Department of Mechanical and Mathematical Engineering/
Mechanical Engineering
Department of Mechanical and Mathematical Engineering/
Mechanical Systems
Department of Computer Science and Electrical Engineering/
Electrical Engineering
Department of Computer Science and Electrical Engineering/
Electronic Engineering
Department of Computer Science and Electrical Engineering/
Computer Science
Department of Materials Science and Applied Chemistry/
Chemistry and Bioscience
Department of Materials Science and Applied Chemistry/
Chemistry and Materials
Department of Materials Science and Applied Chemistry/
Materials Science and Engineering
Department of Science/
Chemistry
Department of Science/
Earth and Environmental Sciences
Department of Advanced Industrial Science/
Environmental Conservation Engineering
Department of Advanced Industrial Science/
Environmental Management and Planning
Department of Advanced Industrial Science/
Architecture and Environment Planning
Department of Advanced Industrial Science/
Building Materials and Structures
Department of Advanced Industrial Science/
Advanced Mechanical Systems
Department of Advanced Industrial Science/
Intelligent Mechanical Systems
Department of Advanced Industrial Science/
Computer Science and Communication Engineering
Department of Advanced Industrial Science/
Frontier Technology for Energy and Devices
Department of Advanced Industrial Science/
Human and Environmental Informatics
Department of Advanced Industrial Science/
Applied chemistry and Biochemistry
Department of Advanced Industrial Science/
Materials Science and Engineering
Master course Medical science major
Master course Medical science major
Master course Medical science major
Education Program for Global Advancement (EPGA) in Environmental, Energy and Health Science
Master Course
Doctor Course
Public Health
Division of Integrated Science and Engineering
Rather not
3 Mar 3 1973 2019 2022
say
Self-employed Uncle
Unemployed Aunt
Fresh Graduate Son
Others Daughter
Cousin
Others
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